Περίληψη:
Two-dimensional shear wave elastography (2D-SWE) has proven to be
efficient for the evaluation of liver fibrosis in small to
moderate-sized clinical trials. We aimed at running a larger-scale
meta-analysis of individual data. Centers which have worked with
Aixplorer ultrasound equipment were contacted to share their data.
Retrospective statistical analysis used direct and paired receiver
operating characteristic and area under the receiver operating
characteristic curve (AUROC) analyses, accounting for random effects.
Data on both 2D-SWE and liver biopsy were available for 1,134 patients
from 13 sites, as well as on successful transient elastography in 665
patients. Most patients had chronic hepatitis C (n=379), hepatitis B
(n=400), or nonalcoholic fatty liver disease (n=156). AUROCs of 2D-SWE
in patients with hepatitis C, hepatitis B, and nonalcoholic fatty liver
disease were 86.3%, 90.6%, and 85.5% for diagnosing significant
fibrosis and 92.9%, 95.5%, and 91.7% for diagnosing cirrhosis,
respectively. The AUROC of 2D-SWE was 0.022-0.084 (95% confidence
interval) larger than the AUROC of transient elastography for diagnosing
significant fibrosis (P=0.001) and 0.003-0.034 for diagnosing cirrhosis
(P=0.022) in all patients. This difference was strongest in hepatitis B
patients. Conclusion: 2D-SWE has good to excellent performance for the
noninvasive staging of liver fibrosis in patients with hepatitis B;
further prospective studies are needed for head-to-head comparison
between 2D-SWE and other imaging modalities to establish
disease-specific appropriate cutoff points for assessment of fibrosis
stage. (Hepatology 2018;67:260-272).
Συγγραφείς:
Herrmann, Eva
de Ledinghen, Victor
Cassinotto, Christophe and
Chu, Winnie C. -W.
Leung, Vivian Y. -F.
Ferraioli, Giovanna and
Filice, Carlo
Castera, Laurent
Vilgrain, Valerie
Ronot,
Maxime
Dumortier, Jerome
Guibal, Aymeric
Pol, Stanislas and
Trebicka, Jonel
Jansen, Christian
Strassburg, Christian and
Zheng, Rongqin
Zheng, Jian
Francque, Sven
Vanwolleghem,
Thomas
Vonghia, Luisa
Manesis, Emanuel K.
Zoumpoulis, Pavlos
and Sporea, Ioan
Thiele, Maja
Krag, Aleksander
Cohen-Bacrie,
Claude
Criton, Aline
Gay, Joel
Deffieux, Thomas and
Friedrich-Rust, Mireen
